Individual
DR. ROBERT S BAIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
615 N BONITA AVE, PANAMA CITY, FL 32401-3623
(850) 769-1511
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 450-6014
(904) 450-6401
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
40125
KY
2085R0202X
Diagnostic Radiology Physician
Primary
ME104942
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001509500
—
FL
01
—
145SJ
BCBS
FL
05
—
64922370
—
KY
Enumeration date
07/01/2005
Last updated
02/12/2020
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